Monday, August 3, 2009

Preventing Cerebral Palsy

Approximately 5000 new cases of cerebral palsy are reported each year in the United States. Great controversy surrounds the cause(es) of cerebral palsy. Various authors have suggested that maternal trauma, bacterial infection, viral exposure, oxygen deprivation prior to or during birth, cigarettes, and plethora of unknowns can cause cerebral palsy.

In a great majority of the cases (over 50%) no specific cause for cerebral palsy can be found. It is known that the greatest predictor of cerebral palsy is prematurity (pre-term labor is defined as the appearance of contractions and dilatation before 37 weeks gestation). Maternal trauma during pregnancy as well as bacterial/viral exposures to the fetus inutero are suspected of being significant contributors to cerebral palsy. Great controversy surrounds the percentage of cerebral palsy caused by physician or nurse errors during labor and delivery. Some authors have suggested that there is no proof that oxygen deprivation during labor and delivery can cause cerebral palsy. The great weight of the evidence on this question, however, suggests that up to 5% of cerebral palsy (250 cases a year in the United States) are the result of physician or nurse errors during labor and delivery.

Because some of the mechanisms capable of causing cerebral palsy are known, certain causes of cerebral palsy may be preventable, avoidable or treatable. These include:

1. Jaundice in newborn infants can be treated with photo therapy. Jaundiced infants are exposed to blue lights that break down bio pigments, thus preventing them from building up and threatening disruption of brain chemistry. In rare cases where this treatment is not enough, physicians can correct the condition with a special type of blood transfusion.

2. Rh (blood factors) incompatibility can be identified by a simple blood test routinely performed during early pregnancy on mothers, and if indicated by history, expectant fathers. Blood typing compatibility does not usually cause problems during a woman’s first pregnancy, as the mother’s body does not produce the unwanted antibodies until after the first delivery. There are exceptions to this.

3. Severe trauma during delivery (e.g. high/mid-forceps, vacuum extraction, aggressive manual rotation, excessive fundal pressure, etc.) can cause skull fractures and/or intra ventricular hemorrages in the fetal/newborn brain. These traumas and/or hemorrhages can cause oxygen deprivation or damage to the cerebral cortex of the newborn’s brain, resulting in cerebral palsy.

4. Some evidence exists that oxygen deprivation during labor and delivery, whether the result of neucal cord, protracted labor, etc. can cause damage to the fetal/newborn’s cerebral cortex, resulting in cerebral palsy.

5. Infectious exposures such as rubella or German measles can be prevented if moms are vaccinated against these diseases before becoming pregnant. Regular pre-natal care and good nutrition, although not directly related to the eliminating of cerebral palsy, are always suggested.

6. It is known that cigarette smoking may lead to small babies and premature deliveries and alcohol/drug consumption can lead to Fetal Alcohol Syndrome and other types of brain damage. Accordingly, physicians should advise their patients to avoid these behaviors during pregnancy.

7. The role of environmental exposures is controversial. Because such exposures tend to be multiple and not single, providing causation is very problematic.

If you, a relative or friend have a family member suffering from Cerebral Palsy and have any questions, please call or visit:


5510 Woodward Avenue

Detroit, Michigan 48202

Phone: (313) 875-8080 or (800) 247-5974

Fax: (313) 875-8522



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